Developing in the
Career Support Role
30th March 2011
Deanery Careers: areas of
activity 2010/2011
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Education
Support and Guidance
Promoting Wales
Workforce
National Links
Careers strategy
Education 2010 - 2011
• Training the trainers – workshops, e learning
(130 Educational Supervisors F2F)
• School Career Leads and FPD (21)
• Foundation workshops (279 F1/344 F2)
• GP Trainees (15)
• Preparing for consultant selection (91)
• MedWales (200 6th formers)
• Medical student lectures
• Mentoring (50)
Careers Education Events
MedWales
Medical Students attending F1
F1 - Planning your Medical Career
F1 - Making Career Decisions
2%
F2 - Applying for Specialty Training
2%
2%
2%
9%
5%
F2 - Future career tactics
2%
23%
F2 - Interview Practice
11%
GPST
SpR - Preparing for Consultant Selection
2%
PGCM - Supporting Doctors w ith Careers
9%
11%
2%
2%
4%
Ed. Supervisor - Supporting Doctors w ith Careers
12%
Ed. Supervisors - Active Appraiser
Postgrad MSc - Supporting Doctors w ith
Careers/Mentoring
Mentoring
Introduction to Career Support
Developing career support skills
F2 destinations 2010
• 245 F2 respondents
• 173 (70%) appointed to specialty
• 128 of these (75%) in Wales and 43 (25%) to
England
• 96% got first choice specialty
• 20 going overseas (Not as many as we think)
• 29 taking career break
• 13 leaving the profession, not known where they
go
Consultant Selection – learning
gaps
• CV quality (too long, too many lists, poor
clinical/non-clinical balance)
• Lack of awareness of what consultants actually
do
• Wales-only view
• Poor grasp of bigger picture (policy, key
players, changes)
• Have trained in the good times, will need to
lead through the tough times
• Need better preparation for transition
Caseload
2009 – 2010
• 39 referrals
• Top 3 sources:
Self, Performance, Ed.
Supervisor
• Top 3 reasons
Progress, change,
leaving
2010 – 2011
• 53 referrals
• Top 3 sources:
Self, Performance, Ed.
Supervisor
• Top 3 reasons
Progress, change,
leaving
Resignations
• A knee jerk response to external factors or
carefully considered decision
• Poor awareness of other options – OOPC,
LTFT, carers leave
• Need for career change or social support?
! Let us know if you or anyone you know is
considering resignation
Returners to medicine
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Supporting Doctors
Out of medicine for 5 – 10 years
Many find a way after meeting us
Started supernumerary posts
Building case for a funded scheme
Let us know if you know of anyone
considering returning to Medicine
Brand Wales
• A Big Issue
• Common misconceptions about Wales
• More joined up promotion of Careers in Wales i.e.
 BMA “We’ll keep a Welcome” campaign/Facebook
 New Brand image – “The Smart Choice”
BUT
Experience of training is a key factor in
recruitment/retention
How the new look was intended to
look…
We weren’t too far off!
New Resources
• New look for DVD and on-line videos: now
clips for WCAT, EM and SAS
• New brand feeding into printed resources and
ST:
http://specialty.walesdeanery.org
• Campaign page
www.walesthesmartchoice.co.uk
• Specialty Leaflets
• F1 & F2 E-Learning modules
• Interactive Career Map
http://careers.walesdeanery.org
Events last year
 Foundation Jobs Fair
 BMJ London and West Midlands (October
2010/11)
 Medsin Conference November 2010
(Swansea)
 Local events (Morriston, Princess of
Wales)
 MedWales 2010 and 2011
and…
Medical Careers Information Day
• Much larger event in 2010 with 36
stands.
• Highest attendance from sixth formers
• Students from as far as Dundee!
• Information giving day for students
and to encourage early planning
• So where are the F1s and F2s?
Statistics
When did they
decide to come?
Who came?
1%
1% 5%
11%
28%
3%
1%
3%
Sixth form
70
Yr 1
60
Yr 2
50
Yr 3
40
Yr 4
30
Yr 5
Intercalated
F1
17%
10
Over a month
ago
CT
10%
4%
Why?
20
0
F2
30%
Series1
1%
Less Than a
month ago
This week
Find out about specialties
30%
2%
Meet doctors and senior consultants
in specialties
Find any career path of interest
Get careers advice
20%
Postgraduate Study
Information about intercalated
degrees
17%
16%
Find out about medical school
Today
For your diaries…
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Our Medical Careers Information Day
Consultants and trainees across all specialties
All Nations Centre, Cardiff
Saturday 15 October 2011
10.00 am – 3.30 pm
Students, Junior doctors, Trainees
Please promote – posters/guides
Help resource stand and workshop speakers
National Careers Activity
• NEAF: Associate Deans with lead for careers
• MCAN: Represented on Committee of
ACGAS UG Medical Careers Advisers
• An emerging professional group: PG
Certificate/Diploma in Managing Medical
Careers
• Presence at ASME, AoME, UKFPO events
(workshops, posters, presentations)
3544 LTFT trainees -Nov 2010
LTFT by Deanery
LTFT Conference/Research
• LTFT Conference on the 1st March, well
attended by Trainees and positively received
• Presentations from BMA, Trainee Rep and
LTFT Advisor
• Research project – mapping destination of
LTFTs over the past ten years.
• Data collection, focus groups and an online
survey
• Results of online survey – 95% of
trainees remained in Wales after
completing training
UK Round-up
Collins Report
GMC surveys
UKFPO update
Collins report
Collins - careers-related issue (1)
All of the appropriate organisations must
work together to define good practice for
the provision of careers information and
advice. Such information must be easily
accessible, simple to understand and contain
transparent data on each specialty, including
competition ratios and a potential applicant’s
“likelihood of success”
Collins - careers-related
issue (2)
Deaneries/Foundation Schools should make a
greater effort to meet one of the important
purposes of the Programme – to ensure that
trainees experience many different
specialties – by maximising and simplifying
access to Tasters and by implementing
organised “swap shops” for trainees to
exchange rotations by 2013. Foundation
Schools should disclose through their local
Deanery website the degree of flexibility allowed
by their programme in a standardised format.
GMC Trainee Survey 2010
• Career management skills and
planning: 55% foundation trainees said they
had been able to develop their career
management skills and career plans and that
the opportunity was useful
• Information to assist career planning: 40%
(48% F2 and 34% F1) knew where to look to
get sufficient information
• 25% said they had received information but
that there was not enough high quality
information in place
UKFPO Annual Report
• Relatively low numbers undertaking GP
placements in F1 or F2 in some
foundation schools (range 30-95%)
compared to the 50% requirement for
GPs in specialty
• There are also issues around
opportunities to experience hard-torecruit specialties in foundation
Tasters for Foundation doctors
• Standardised guidance for effective tasters
on the UKFPO website and also in the
Foundation Programme Reference Guide.
• Rough Guide to the Foundation Programme
(2010 edition) contained comprehensive
guidance on tasters.
• Do you provide tasters in your specialty /
location?
UK Careers Issues
• Work ongoing to agree presentation of
2011 competition ratios
• UK MCWG future ?
• UKFPO Careers workstream to March
2011
• NEAF and MCAN meetings ongoing
• MSC developing information for school
leavers contemplating a medical career
• Future setting of deaneries in England?
Workforce – many sources
• NLIAH report – overview and speciality
reports
• CFWI report – reducing numbers in some
specialities
• Collins report on Foundation programme –
Autumn 2010
• BMA Cohort Study – 4th report
• UKFPO warns of shortfall of F1 posts for
2011 – September 2010
• Junior doctors desert the NHS – Times, Sept
2010
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% of entry level posts
Vacancies leading to CCT - 2010
Career Options 2010 - Posts leading to CCT
53
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50
44
40
England
30
Scotland
Wales
19
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Activity 1
Delivering a Career Planning
Workshop
Plan 20 minutes delivery:
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Group 1 Slides 1 – 14 (first 3 objectives)
Group 2 Slides 15 – 16 (objective 4)
Group 3 Slides 17 – 25 (objective 5)
60 minutes total
Learners must engage and participate, ask
questions
• 15 minutes feedback
Career Theory - Update
Theories of career
decision making
• Person-Environment Fit Theories e.g. work of
Holland
• Developmental Career Theory e.g. Super
• Psychodynamic Theories
• Structural Theories e.g. Roberts
• Law’s Community Interaction Theory
• Narrative approach to careers e.g. Cochran
Counselling theories
Person Centered Approaches (Derived from the work of Carl Rogers)
–congruence, unconditional positive regard and empathic
understanding
‘Person-centered career counselling is a relationship between a
counsellor and a client, arising from the client’s concerns, which
creates a psychological climate in which the client can evolve a
personal identity, decide the vocational goal that is fulfilment of
that identity, determine a planned route to that goal, and
implement that plan. The person-centered career counselor
relates with genuineness, unconditional positive regard and
empathy; the locus of control for decisions remains with the
client out of the counselor’s trust in the self-actualizing tendency
of the individual. The focus in person-centered career
counselling is that of attitudes and beliefs that foster the natural
actualizing process rather than on techniques and goals.
(Bozarth J.D and Fisher, Rl (1990). Person-centered career counseling. In W.B. Walsh and
S.H. Ospiow (Eds). Handbook of Vocational Psychology. Mahway, NJ: Erlbaum
Emerging Career Theories
• Narrative Theories
• emphasise the process of reinterpreting the past in order to develop
and maintain a coherent story, rather
than just the existence of memory of a
consistent past
• emphasises ‘emplotment’ - the process
of viewing the self as the main character
in a meaningful and productive narrative
Emerging Careers Theories
• Career Learning and Storyboarding
• SeSiFU – sensing, sifting, focusing and
understanding
• storyboarding aimed at enabling clients
to find out ‘What’s going on?’ and to
work out ‘What can I do about it?’. It
focuses on reflecting on a turning point
in a person’s life and gives clients the
opportunity to explore their own
capacity for flexibility
Emerging Career Theories
• Happenstance (chance)
• Counsellors need to teach clients to engage in exploratory
activities to increase the probability that the clients will discover
unexpected career opportunities. Unplanned events can
become opportunities for learning.
• The ultimate goal of career counselling is creating
satisfying lives, not just making a decision
• Practitioners should get clients to engage in
exploratory action
• Open-mindedness should be celebrated, not
discouraged
• Benefits should be maximised from unplanned events
Emerging Career Theories
• Systems theory framework (STF)
social contextual systems – the principal social influences within
which individuals interact and/or receive input from e.g. family,
community, media, education etc.
environmental/contextual systems – things like geographical
location, political decisions, historical trends, labour market etc.
• Chaos theory
draws attention to the complexity, changeability and
connectedness of the components of career development
complexity, change, chance
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• Cultural capital
increased focus in widening participation into medicine and
medical school
Skills session
• 1:1 Discussion exercise
• Review of Core skills
• Case studies
1:1 Discussion Exercise
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Working in pairs
Topic -Where you grew up
3 minutes to ask questions and take notes
Swap
• 3 minutes to talk about where you grew up
• Swap
Core skills
Ali and Graham (1996) provide a clear
account of the essential skills that are used
in career counselling (and in fact, in any
counselling relationship). According to this
model, certain skills are more basic than
others – although all levels of skills are
essential for an effective counselling
relationship.
The Skills Pyramid
Interpretative
Skills
More
Influence
Strengthen
Empathy
Understanding
Skills
Active
Listening
Skills
Ali, L. and Graham, B. (1996) The counselling approach to career guidance. London: Routledge, an imprint of Taylor and
Francis Books Limited
More about the Skills Pyramid
• Interpretative skills – challenging, immediacy,
self-disclosure and providing information
• Understanding skills – restating,
paraphrasing, summarising and asking open
questions
• Active listening skills - this term means
listening to: the content of what is being said,
how it is said, the possible meaning behind
the words, the feelings expressed and the
nature of any silences. It is used through the
whole session
Four stage model
Clarifying
Exploring
Action Planning
Evaluating
Ali, L. and Graham, B. (1996) The counselling approach to career guidance. London: Routledge, an imprint of Taylor and
Francis Books Limited
Clarifying
Tasks
• Setting the scene
• Developing empathy
• Hearing the clients story
• Making an initial
assessment
Skills
• Developing and
conveying empathy
• Active listening
• Paraphrasing
• Summarising
Exploring
Tasks
• Building the contract
• Exploring the issues
within the contract
• Encouraging the
client to explore
other options
• Re-examining the
contract
Skills
• Active listening
• Skilful questioning
• Paraphrasing
• Summarising
Evaluating
Tasks
• Challenging
inconsistencies
• Enabling the client to
weigh up the pros and
cons for each option
• Prioritising options with
the client
• Re-examining the
contract
Skills
• Active listening
• Questioning
• Challenging
• Providing information
• Self-disclosure
• Being specific
Action planning
Tasks
• Helping the client
identify what needs to
be done
• Encouraging the client
to formulate an
appropriate plan of
action
• Introducing the concept
of referral if necessary
• Reviewing the contract
• Ending the interview
Skills
• Developing and
conveying empathy
• Active listening
• Paraphrasing
• Summarising
Case studies
• In groups of 4
• Read case study allocated
• Using 4 stage model how would you
approach working with this trainee?
Summary and next steps
Help for the Helpers
• “Supporting Doctors with their Careers” and
“Being an Effective Mentor”
• 2 hour sessions for Educators
• 2 CPD points from RCP
• Opportunity for interaction, reflection, discussion
• We can run – or so can you!
• Also on-line module based on London Deanery
materials, on PLATO (which you previewed)
• Aligns with PMETB domains for Educational
Supervisors
And finally…
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Our resourcing is changing a little
Wider range of workshops
Caseload increasing
More Wales PR and promotion
Admin and financial resources stretched
So…
We really do need your
help with…
• Specialty information for leaflets
• Delivering F1 workshops
• Medical Careers fair on 15th October
2011 and BMJ (Foundation, specialties)
• Promoting, organising and co-delivering
training for Educational Supervisors
The role of the career lead…
…say “no” to Sat-Nav!
Thank you!